The J&J vaccine is back. Next comes confidence.

Seema Shah, a bioethicist at Lurie Children’s Hospital in Chicago, says that while the break wasn’t ideal, moving forward with the Johnson & Johnson vaccine without stopping to investigate the clots would have been worse.

“I keep thinking about the counterfactual,” he says. “If the FDA hadn’t stopped, what kind of signal would this have sent?”

Having options can increase confidence

Many healthcare providers and government officials have seen the Johnson & Johnson vaccine, which uses conventional viral technology to deliver the necessary genetic instructions, as a useful alternative to mRNA vaccines from Pfizer and Moderna. Because it only requires one dose, it is well suited for people who may not stay in one place long enough to schedule a second dose, such as students and people experiencing homelessness.

Many other people just prefer the one-shot option – whether it’s for convenience or because they don’t like needles to begin with. Site and shift workers may have narrow windows in which they can go to an appointment for a vaccine, making Johnson & Johnson a better option.

The Johnson & Johnson vaccine is also easier to distribute and administer because it does not need the particularly cold storage temperatures required by mRNA vaccines. This makes it convenient for vaccinating homebound patients, residents of rural communities, and patients in pop-up clinics who may not have special freezers.

“If the FDA hadn’t stopped, what kind of signal would this have sent?”

Seema Shah, bioethicist at Lurie Children’s Hospital in Chicago

But despite these benefits, the vaccine created mistrust after manufacturing issues and studies that have shown it was less effective in preventing infections: while the Pfizer and Moderna vaccines were 95% and 94% effective against symptomatic infections, the Johnson & Johnson vaccine was 72% effective against moderate to severe cases. While the comparison isn’t perfect, seeing the headlines about inferiority can add up, and those who work to build trust should heed that.

“It will take important messages to help people understand that we are not forcing the wrong vaccine on you – there is no wrong vaccine that we would allow to continue using,” says Fernandez Lynch. She also notes that doctors will now have to communicate with patients to gain their trust. They are the ones who may explain the relatively low risk of side effects or suggest alternatives to those affected.

Building that confidence is a long game, she says, “It’s not just today; it’s not just the J&J vaccine; it’s not just a question of covid vaccines. It is a matter of trust in science, government and public health. “

This story is part of the Pandemic technology project, supported by the Rockefeller Foundation.

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